Does King-Harbor's staff need emergency treatment?

Today, Hicks and Hutchinson debate the problem of fixing an underperforming staff. Wednesday they discussed how closing the troubled hospital would affect the local community. Friday, they'll discuss how the situation became such an emergency.

Civil service rules impede efforts to fix problems at King-HarborBy Joe R. Hicks

Few have argued that the major issues at King-Drew, now renamed King-Harbor Hospital, have revolved around service protections. This is like arguing that teachers unions are the major problem in the inability of public education to raise test scores, close the racial learning gap and lower the student dropout rate. Teachers unions are a large part of the problem, not the problem. Similarly, civil service protections have made the process of eliminating nonproductive staff at King-Harbor (or in any public employee circumstance) a lengthy, time-consuming and difficult process. As we know, civil service protections are designed to discourage "frivolous" disciplinary procedures and terminations. So be it.

But at an institution like King-Harbor, with the publicly-affixed moniker "Killer King," civil service protections have acted to shield hospital staffers who have acted in ways that all too often endangered the well-being of patients. At an institution like a public hospital this can be, and has all too often been, a matter of life and death. Federal investigations of staff problems at King-Harbor have indeed tended to hold administrators or supervisors accountable for the harm done to the public—pointing to them as the source of bad training and poor leadership that has led to critical, life-threatening lapses in performance. But c'mon, it doesn't take additional training to tell a nurse that turning off a patient's heart monitor, while she took a break, was not a particularly good idea—an incident one newspaper reported occurring at King. Truth be told, the problems at King-Harbor go far beyond a simple matter of retraining existing staff. When a culture of neglect and callousness has impacted the level of care, then drastic measures are called for to eliminate the dangerous tendency to kill patients.

It is because of civil service protections that current staff at King-Harbor may be "shared" with other area hospitals in the event that the hospital is forced to close. Some of these employees may be, you state, "effective" and "efficient" employees. But here's the rub...some of these King-Harbor employees are not of this type and may be either lazy, incompetent, recalcitrant or a combination of all these maladies. Of course the other complicating factor in attempting to deal with the staffing "issues" is that public employee unions, just like teachers unions, go to extreme lengths to protect those employees operating under the debilitating, restrictive contracts extracted from the county by union bosses. This is the toxic combination—civil service protections buttressed by militant, highly political public employee unions.

To be sure, these problems of labor and management exist at every other hospital in the Los Angeles County healthcare system. However, it is at King-Harbor that the toxic combination of racial patronage, an aggressive racial preference hiring system, the soft bigotry of benign neglect by L.A. County political leadership, civil service rules and politicized public employee unions have all worked in a fashion that gives the institution perhaps the worst reputation of any big-city hospital in the nation. Let's close King-Harbor down and start from scratch.

Joe R. Hicks is vice president of Community Advocates Inc., a Los Angeles-based human relations organization. He is currently writing "What's Race Got To Do With It: Building Bridges Across America's Racial Quicksand."

Civil service rules have nothing to do with King-Harbor's problems By Earl Ofari Hutchinson

You got one thing partly right: Civil service protections aren't the sole reason for King-Harbor's alleged failings. That's a frank, even startling admission from someone who thinks unions are a prime impediment to the smooth, effective and efficient functioning of schools, service agencies and hospitals such as King-Harbor. But you then predictably take your partial moment of revelation back with your wrongheaded charge that civil service protections have acted to shield hospital staff.

Like so many myths about the supposed failings of King-Harbor hospital that you and King-Harbor antagonists spew as articles of faith, the notion that civil service rules have anything to do with the problems at the hospital has absolutely no basis in fact. You cite no evidence, even anecdotal, to bolster your contention that King-Harbor has been ruined by a legion of lazy, incompetent employees. The truth is that a targeted number of incompetent nurses and medical personnel at the hospital were put on administrative leave, reprimanded, disciplined, or nudged toward resignation and even terminated for failure to perform.

The best example of that was the nurse blamed for the emergency room death of Edith Rodriguez. She was promptly put on administrative leave, later resigned, and was reported to the California Nursing Board. In the 15 inspections the U.S. Centers for Medicare and Medicaid Services (CMS) made of King-Harbor operations between 2003 and 2006 (the inspections that got King in hot water), the feds never pointed the finger of blame at incompetent staff. Instead, they pointed it at management and supervisors. Despite the warnings, they still failed to render proper and timely hands-on training, oversight, monitoring and follow-up of the negligent employees.

You say, "Hey it doesn't take training to tell a nurse to turn off the heart monitor while on break." But it does! CMS was not talking about simply turning a switch on or off. The agency was talking about the operation, procedures and monitoring of the equipment. I don't know what else one could call that other than training, or lack thereof—especially considering that CMS in successive reports found the same problem. Curiously, in your big, mostly media-gleaned, sweeping indictment of King-Harbor's woes, you blame racial patronage and a racial-preference hiring system for them.

Talk about having your cake and eating it too. You argue that civil service is a prime culprit in damaging King-Harbor. Civil service rules insure that candidates for public service jobs meet defined standards of education/and or experience. The standards are measured by tests, interviews and a probation period, and that's been the case at King-Harbor. The idea is to eliminate cronyism and favoritism, and to keep those who are blatantly incompetent and unqualified out of public service jobs: the very things that you erroneously claim caused King-Harbor's downward spiral. Mercifully, the CMS didn't listen to you, the L.A. Times and the supervisors when they gave King-Harbor a passing grade this week. Thank the hardworking, dedicated (and yes, thankfully civil-service protected) employees at the hospital for that!

Earl Ofari Hutchinson is an author and political analyst. His new book, "The Latino Challenge to Black America: Towards a Conversation between African-Americans and Hispanics," will be out in October.

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